Provider Demographics
NPI:1194756023
Name:CARSTEN, JAMES F (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:F
Last Name:CARSTEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4976 ALPHA LN
Mailing Address - Street 2:
Mailing Address - City:HIXSON
Mailing Address - State:TN
Mailing Address - Zip Code:37343-5470
Mailing Address - Country:US
Mailing Address - Phone:423-497-5355
Mailing Address - Fax:423-308-0281
Practice Address - Street 1:9309 APISON PIKE
Practice Address - Street 2:
Practice Address - City:OOLTEWAH
Practice Address - State:TN
Practice Address - Zip Code:37363-4340
Practice Address - Country:US
Practice Address - Phone:423-551-3562
Practice Address - Fax:423-551-3563
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036080965207Q00000X
TN63261207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0222075OtherBLUE CROSS GROUP NUMBER
IL036080965Medicaid
ILK20930OtherMEDICARE PTAN (INDIVIDUAL)
ILP00245860OtherRR MEDICARE PTAN (INDIVIDUAL)
IL548190Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER
IL0222075OtherBLUE CROSS GROUP NUMBER